Dáil Éireann debate -
Thursday, 3 Nov 2011

Vol. 745 No. 3

Topical Issue Debate

School Staffing

Deputy John O’Mahony

I thank the Leas-Cheann Comhairle for selecting this topic and I thank the Minister for coming in to hear it. The matter is simple. As everyone is aware, by 29 February next a large number of teachers will have retired because of the changes to be introduced in pension and taxation calculations. I have raised this issue on several occasions previously. If the changes go ahead as scheduled it would create a great deal of confusion and disruption in the classroom, especially for examination classes.

This is especially relevant for those sitting the leaving certificate examination. The changes will come during the final ten to 12 weeks of the school year, the most important part of their education in secondary school. During this time there are mock examinations, oral and practical examinations and the final lead-in to the leaving certificate examination. At that stage, the teacher is not only a teacher, but a mentor for the students and a calming influence. Teachers offer guidance on the crucial areas to revise and suggest areas likely to be examined. This takes place in the final days before the examinations.

If the planned changes go ahead it would represent an impossible task from the student's point of view for any new teacher who might step into the classroom on 1 March to oversee a smooth or seamless transition. I emphasise that I have in mind the student's point of view and this is no reflection on the competence or qualifications of any new teachers who might enter the classroom.

I raise the matter for a second reason. A newspaper report some weeks ago suggested the Minister was considering some way of alleviating this disruption. This has ignited a good deal of confusion, tension and concern on behalf of the students with regard to what will happen in February. I understand there is some time to go but will the Minister confirm, inasmuch as he can at this stage, what will happen in classrooms, especially for leaving certificate students? If there was an indication of what will happen, students could put their minds at ease, know exactly what was happening and be able to concentrate on getting the maximum points in the leaving certificate next June.

Minister for Education and Skills (Deputy Ruairí Quinn)

I thank Deputy O'Mahony, with whom I served on the committee on education and skills in the last Dáil, for raising this matter.

The previous Government provided for a reduction in the pay of public servants in 2009. Under the public service pension rights order 2011, 29 February 2012 was set as the final date on which public servants could retire and have their pension entitlements calculated on the older, higher rates. It is possible, due to this effect on pensions, that there may be an increased turnover of teaching staff in the next few months. Deputy O'Mahony is an expert in this field as a former teacher.

The Government is very aware of the potential impact on students preparing for the two State examinations of an increased number of teachers retiring between now and next February. To reduce this impact I intend to permit schools to re-employ teachers who choose to retire between 1 December 2011 and 29 February 2012 and who, immediately before their retirement, had been teaching students preparing to sit the junior or leaving certificate in 2012. These teachers may be re-employed until the summer holidays for the teaching duties for which they were timetabled immediately before their retirement.

Where a teacher's pre-retirement duties included teaching and non-teaching duties, such as in the case of an assistant or deputy principal, the teacher may be re-employed for his or her teaching hours only. These measures will be confined to teachers teaching State examination classes in post-primary schools and do not apply to teachers with no exam classes or primary school teachers.

Where teachers retire who are not involved in teaching in some classes then replacements should be employed until the end of the school year, in accordance with normal recruitment practices. This involves a full recruitment process for appointments in excess of 24 weeks or, where the vacancy is for less than 24 weeks to the end of the school year, the school should appoint a substitute teacher. Officials in my Department have discussed this matter with second level management bodies and expect to issue an information note to schools in the next week.

Deputy John O’Mahony

I thank the Minister for addressing the situation ahead of time. What he has said will be very good news for students at this critical stage of the school year. I ask him to confirm that all State examinations will be covered, including the junior certificate. Does the Minister know how many teachers have indicated they will retire in the coming months to 29 February in primary and post primary schools?

Deputy Ruairí Quinn

The Deputy has asked two specific questions and I propose to answer him in the order in which he asked them. This transitional facility will apply to teachers who are involved in the junior certificate examination as well as those teaching the leaving certificate. If teachers were assistant principals or principals they will be paid the teaching rate as a regular teacher and not receive any additional rates after they receive their lump sum and entitlements. It is confined to bridge the gap. February was, relatively speaking, an arbitrary date. The scheme is to be introduced to make sure there is continuity to the end of the academic year and ensure there is no disadvantage to students doing mock exams and leaving and junior certificate examinations.

What was the second question?

Deputy John O’Mahony

I asked about the numbers who have indicated they wish to retire.

Deputy Ruairí Quinn

It is a voluntary scheme. Teachers have three months in which to signal their intention to retire and we cannot anticipate what the quantum will be. There is an expectation, not just in the education sector but across the public service, that people will avail of the option to retire if it suits their position in life to do so. The matter is entirely up to people to decide. Therefore, I cannot give the Deputy a concrete figure.

Ferry Services

Deputy Michael McCarthy

The Fastnet Line has been placed into interim examinership. The genesis of the service was a co-operative movement in west Cork. It is hugely valuable and has been very important economically in the Cork and Kerry region. The service has been hampered by fuel costs. It will be shelved and from 2012 will no longer run between October and March. Fastnet predicts that services will resume on 6 April 2012 until the end of September, as per its restructured viable business plan.

As part of a broader restructuring of the management team over the past four months, with the principal focus on improving and stabilisingthe financial statusof the company, the decision to cancel the service between Cork and Swansea has happened in a sudden and unexpected manner. It is of profound concern to people across the south west, including passengers, staff members and shareholders. The business employs several full-time shore employees in Cork and there is an average of 53 full-time contract staff on board the MV Julia at any given time.

The move has also had immediate implications for the 400 shareholders who have generously invested in the company and whose unprecedented support for the service since its inception can never be underestimated. These people need comprehensive assurances and explanations on the appointment of the examiner and the implications for them.

Deputy Ciarán Lynch

I thank the Leas-Cheann Comhairle for allowing this debate. The Cork to Swansea ferry has announced the suspension of sailings. The service was launched on 10 March 2010 following the acquisition of a new ship, the MV Julia, and has carried 150,000 passengers to date. Fastnet suspended all services on 1 November following its placement into examination by the High Court. The company has debts in excess of €10 million. However, all intending passengers have been offered refunds on their fares which is a welcome development.

The original service linking Cork to Swansea ran from 1987 to 2006. Following the wind-up of the company it was terminated and recommenced in 2010 when a new company set up under a co-operative which engaged with many small local businesses in Cork, Kerry and Munster. It was seen as a venture which would have a mutual and broad beneficial gain for businesses in the region, particularly those involved in tourism. It was also perceived that the roll-on roll-off freight service from the UK to Ireland would benefit other ancillary businesses. As Deputy McCarthy said, current fuel prices have also contributed to the difficulties the company has faced.

I welcome the Minister for Transport, Tourism and Sport to the Chamber to discuss this important issue. The news of the Fastnet Line examinership has come as a huge shock to many in Cork and Kerry. I spoke to Deputy Arthur Spring this morning. In the second quarter of this year tourism figures increased by 15%, which must be related to the reintroduction of the ferry service.

The company has stated its intention to resume sailings in the summer period next year, albeit on a more restricted basis. It is a welcome development. I will be interested in hearing what assistance, if any, the Minister's Department can provide in the context of recommencing the ferry service between Swansea and Cork.

Minister for Transport, Tourism and Sport (Deputy Leo Varadkar)

I thank the Deputies for raising this matter. I share their concerns and their disappointment regarding this development.

Neither the Department of Transport, Tourism and Sport nor any of its agencies has any function in respect of or, more pertinently, finance for the subsidisation or provision of ferry services for this or any other route. Following the suspension of the service offered by the Cork Swansea Ferry Company in 2007, the West Cork Tourism Co-Op was formed in early 2009 with the objective of relaunching the service. In September of that year, the co-op purchased a vessel, the MV Julia. This transaction was financed through equity raised from local small investors and a bank loan. I take this opportunity to acknowledge the substantial local support afforded to this project.

In October 2009, the co-op announced further investment opportunities through an additional share offer and by means of a sale of secured corporate bonds. As a commercial State entity under the aegis of my Department, the Port of Cork Company took a commercial decision to purchase bonds totalling €300,000 in the service. This was a small investment relative to the size of the port company. The most recent investment was approved by my Department and the Department of Public Expenditure and Reform. Four other parties took up the public offer to purchase bonds. These include three public bodies — Cork County Council, Cork City Council and Kerry County Council — and the Clona Milk Co-Operative. In 2010, Enterprise Ireland approved an investment in Fastnet Line Operators Limited of €1 million in redeemable preference shares, on full commercial terms, to complete the funding round. This investment represented less than 10% of the overall funding round.

Enterprise Ireland made investments in Fastnet Line Operators Limited in 2010 and 2011 totalling €1 million by way of redeemable preference shares, on full commercial terms. Furthermore, Finance Wales, a body under the auspices of the Welsh Assembly, also agreed to invest in the business. The Fastnet Line had sufficient funds to launch and operate the service from March 2010. In that year, the ferry service recorded a €2.5 million operating loss over ten months. This was despite the increase in the number of passengers using ferry services as a result of the volcanic ash crisis.

The Cork-Swansea ferry resumed sailings in March 2011, after the winter months, and it was planned to extend the sailing schedule in 2011. On 1 November 2011, ferry sailings were suspended when the High Court appointed Grant Thornton as an interim examiner to the company. As the Deputies will be aware, this is a court process over which neither Parliament nor the Government has any control.

In addition to the commercial investment made by the Port of Cork in the ferry service, as well as Enterprise Ireland's investment, my Department, from the tourism side, has been supportive of the development of the Cork-Swansea route by the Fastnet Line. However, we are bound by the EU state aid rules and limitations these impose. That said, however, early on both Fáilte Ireland and Tourism Ireland were — as is the case with other air and sea access routes — involved in discussions with the promoters to support the service through active promotion and marketing. Subsequently, advertisements were placed, on a co-operative marketing basis with Tourism Ireland, in UK national and regional newspapers in order to promote the service to British tourists.

Fáilte Ireland also worked with the Fastnet Line to provide it with business support training. The training on offer ranged from web to marketing, finance, sales and practical culinary and hospitality-customer service supports. These were designed not only to ensure a quality passenger experience but also to deliver benefits such as cost savings and increased sales and revenue and, ultimately, to improve viability. In addition, Fáilte Ireland granted BES certification to the enterprise to assist it in raising finance and the line launched a drive to raise €1.5 million in funding. That kind of support from Fáilte Ireland and Tourism Ireland will remain available to the current operator, if it can resume sailings, or to a replacement operator.

I am disappointed that the service has run into difficulties. I am aware that there is a great deal of community and business support behind it. An access route such as this into the south west is beneficial to the region and I hope that the operator can find new financing to continue the service. I understand that a restructured business plan has been presented by the company as part of the examinership process and forecasts that the ferry service will resume in April 2012. However, ferry services must operate on a commercial basis and to do so must have the support of a sufficient customer base. It is not the function of the Department of Transport, Tourism and Sport — nor is the facility available — to provide finance for such ferry services. Moreover, to do so could, if traffic from unsubsidised services were to be displaced as a result, constitute illegal aid on the part of the State.

Deputy Michael McCarthy

I thank the Minister for coming before the House to take this matter. To date, the service has carried over 150,000 customers, 75% of whom have UK addresses. This highlights the absolute dependence of the south-west region on tourism. The Minister came to the region during the summer to open the Mizen Head Bridge, which has been short-listed for an international engineering award. The ferry service is vital and the benefits to be had from tourism have an impact throughout the entire south west. In many ways, retention of the service would have the knock-on effect of reducing the reliance people who have lost their jobs have on social welfare payments. This matter highlights the importance of tourism to the region.

Deputy Ciarán Lynch

I thank the Minister for his reply. I acknowledge his comments to the effect that no State intervention can be made because this could be perceived as a breach of European Union state aid rules. It is a matter of EU law that neither this nor any other member state can subsidise private ferry operators.

In view of the unique structure relating to the company which provides the service, that is, the fact that businesses, local authorities and other interests in the south-west region were involved in getting it up and running, will the Department provide assistance in the context of analysing where the company went wrong? If such an analysis were carried out, it might facilitate the putting in place of a business plan whereby a new ferry service could be provided, albeit on a more limited basis, during the summer months. I am of the view that there would be merit in the Department carrying out a detailed analysis with regard to how a new service might be put in place and how it might operate.

Deputy Leo Varadkar

Deputy McCarthy was absolutely correct when he stated that rising fuel costs have not been of assistance in this matter. The difficulty we face with regard to ferry and airline services is that fuel costs are going to rise in the long term. Such costs may fluctuate but their long-term trajectory will be upwards with new environmental regulations relating to the sulphur content of fuels, ferry services will become much more expensive. That is an underlying problem with which we will be obliged to deal.

While State aid has not been provided, a great deal of assistance has been forthcoming in the form of commercial investment. Such investment was made not just by local people, but also by the county and city councils, Enterprise Ireland and the Port of Cork Company. However, there comes a point where investment of this nature is no longer commercial. The support provided by Tourism Ireland and Fáilte Ireland remains available and will still be in place in the future. I recognise the tourism benefits of facilitating direct access to the south west. People have the alternative of entering the country through Rosslare. Given that the latter is situated quite a distance from the south west, however, tourists may not be prepared to continue their journey to the region. I will make representatives from Fáilte Ireland and Tourism Ireland available to work on business plans and marketing and co-operation initiatives. I am happy to take on board the suggestions put forward by the Deputies in that regard.

Hospital Closure

Deputy Sean Fleming

I wish to share time with Deputy Stanley. I thank the Ceann Comhairle for allowing me to raise the issue of the closure of Abbeyleix Community Hospital. I wish to condemn the decision that has been made in this regard. The decision is wrong and it should be reversed. The 21 patients and the 60 or so staff at Abbeyleix Community Hospital were stunned when the decision was announced yesterday. The former were obliged to contact their families and relatives to inform them of it. No one saw this decision coming and, as a result, it caused major shock. It is not necessary to close Abbeyleix Community Hospital and if the decision is the subject of a proper re-examination, then I am of the view that it will be reversed.

The HSE is moving with indecent haste in this matter. It wants to transfer the patients from their long-term home — some of them have been there for a number of years — to alternative accommodation. Many of the patients are elderly and they have become accustomed to life in the hospital. I take this opportunity to compliment the staff at the hospital on the quality of care provided there. HIQA has had no difficulty with the facility in recent times.

While the HSE has not made any announcement in respect of the 90 people who attend the day-care facility for the elderly at the hospital or those who access the speech and language therapy, physiotherapy and meals on wheels services provided there, I am concerned that when the main unit is closed these services will be discontinued next year. The matter will be the subject of a fudge until all the patients are removed from the hospital. The decision to close Abbeyleix Community Hospital is purely financial in nature; it does not relate to making savings. I am of the view that it should be revisited because there are no real savings to be made in this instance. I ask the Minister to address this matter.

Deputy Brian Stanley

I thank Deputy Sean Fleming for sharing time. The decision to close this facility, which was announced yesterday, is absolutely devastating, particularly for the people of south Laois. It is a top-class facility and there are no safety issues relating to it. We have been informed that the decision to close it relates to budgets. However, as of this morning, the local senior manager at the HSE was not in a position to indicate how much money will be saved through the closure of the hospital.

There are 45 staff at the hospital and they care for 32 people — 28 nursing patients and four respite patients. The Minister can lift the embargo because the number of staff is adequate. The issue of HIQA has been raised. Major refurbishments have taken place in that hospital in recent years. It is a top class facility and I do not believe that issue can be used. It is simply part of a privatisation agenda.

We have an ageing population and south Laois is not exempt, nor is the county of Laois. Relatives of mine have been inpatients of that hospital. Friends, neighbours and family members have been in that excellent facility. I ask the Minister to reverse the decision. It is shameful that it was announced four hours after €711 million was handed over to unguaranteed bondholders in Anglo Irish Bank. I ask the Minister to revisit this decision. I believe the facility is viable and I ask him to reopen it, keep it open and ensure it remains in place in Abbeyleix.

Deputy Charles Flanagan

I too wish to express my disappointment in the HSE on foot of this decision which I regard as hasty and unnecessary. It is dressed up as a cost saving. I ask the Minister to inform the House of the efforts made by the HSE to save costs in administration in other areas rather than hit frontline services in Laois.

I visited the regional hospital in Portlaoise last week and saw 21 people on trolleys by dint of the fact that all the medical and surgical wards are occupied by people who are undergoing long-term treatment, most of whom are elderly. Where are these people in Laois to receive long-term residential care? Abbeyleix must be linked closely with Mountmellick. St. Vincent's hospital, Mountmellick, is an excellent facility, where at least two wards have been closed for some time. I take it the staff in Abbeyleix will be redeployed to Mountmellick and that Mountmellick will re-open, expand and develop. I ask the Minister to reassure the residents who must leave Abbeyleix nursing unit that they will be looked after and to state where they will be looked after.

On foot of what study or information on long-term care of the elderly was this decision made? I understand there are more than 2,000 adults in Laois who are over 80 years of age. Most of those who needed care received it either in St. Brigid's hospital, Shane, the district hospital in Abbeyleix — which I understand is to close — and in St. Vincent's hospital, Mountmellick. There is a question mark over the future of St. Brigid's hospital, Shane, which I want cleared up and the matter addressed. I ask the Minister to assure the people of County Laois that care of the elderly will be such as is required by the thousands of people who have reached old age, most of whom have served the State well in terms of paying their taxes and their contribution to society and who have a question mark over their final years. This is a wrong decision which was hastily taken. I would like to see a full briefing note as to how the HSE decided to undertake this move in Laois at a time when hard-pressed families are experiencing grave difficulties.

Minister for Health (Deputy James Reilly)

I thank the Deputies for raising this issue. It provides me with an opportunity to update the House on this matter.

Abbeyleix community nursing unit provides continuing care, day care and respite services to people in Laois and Offaly and the bordering areas of Kilkenny, Carlow, Tipperary and Kildare. It is a two-storey building, formerly a fever hospital, acquired by the Midland Health Board in 1960. Residents live on the ground floor which is divided into two separate units. The unit has a maximum capacity of 50 beds. At present there are 28 residents, all with maximum dependencies. Four respite beds are in use.

The Health Service Executive has advised that the reducing funding allocation being experienced across all HSE services, together with staff losses as a result of the public sector moratorium, combined with the anticipated losses of staff between now and the end of the year, make it essential that it now moves to consolidate the overall provision of long-stay care within the Dublin and mid-Leinster region.

An inspection report published by HIQA in February 2011 concluded that the ratio of staff to residents at the Abbeyleix unit was not adequate to meet the needs of the mainly maximum dependency residents. It also noted that the building is old and has a number of multi-occupancy bedrooms which do not meet the requirements of the national standards. Taking all these factors together, the HSE took the decision to proceed with the closure of Abbeyleix community nursing unit. It will also consult and communicate with residents families, staff, public representatives and key people in the wider community including Friends of the Hospital, Age Action, local GPs, clergy and the Garda.

The selection of an alternative placement for residents will be informed by the medical and care needs of each resident as evaluated by clinical staff. The implementation plan will also take into consideration the proximity of the identified nursing unit to the relatives. It is intended that the residents will be transferred to public units, where appropriate, and that the remaining residents will be transferred to private nursing homes. Staff from Abbeyleix community nursing unit will be transferred to re-open closed beds or prevent the closure of other public beds resulting from moratorium losses in the area or both.

In relation to the other services provided at Abbeyleix community nursing unit, I can confirm that the day care services will continue to cater for the needs of the 90 clients — approximately 24 per day — who use the service, and there are plans to further enhance this service in the future. The respite service for the current eight clients will continue, but it is intended that this service will transfer to a private provider following consultation with the families concerned. I also assure the House that the primary care centre located on the grounds of the facility will also continue in line with the HSE primary care strategy.

The changes to the service I have outlined will help to ensure that the HSE will achieve the highest standards of care for the most efficient deployment of resources.

Deputy Sean Fleming

I thank the Minister for the bland and general response and failure to deal with the issue. The decision to close Abbeyleix community nursing unit is exclusively a financial one. I ask the Minister to take this on board as the basic situation in Abbeyleix community nursing unit. The payroll bill is €2.6 million. All the staff can be redeployed to Portlaoise, Mountmellick and other areas so there can be no savings as a result of the closure. Most of the 30 patients will transfer to private nursing homes at a cost of approximately €1,000 per week for 50 weeks of the year, incurring an additional cost to the HSE of private nursing care of €1.5 million. This decision is solely about the HSE making a decision to replace one set of private operators, that is, agency staff, with another set of private operators, namely, nursing homes. This is purely a financial decision. The Minister did not deal with the figures. We want to see the case being made on financial grounds, as stated by the Minister. He said the decision was based on anticipated losses. Therefore, he is only guessing what might happen. That is not a reason to make a decision now.

In regard to where the residents will have to move he said the "selection of an alternative placement for residents will be informed by the medical and care needs of each resident as evaluated by clinical staff". In other words, they will be told where to go by the medical staff. That is not good enough and I ask the Minister to address the issue.

Deputy Charles Flanagan

I ask the Minister to reassure the House and, in particular, the Deputies who represent the area that the long-term health care needs of the elderly in County Laois will be adequately catered for, notwithstanding the decision of the HSE. I would like to know when and how this will be done.

Deputy Brian Stanley

May I ask one question?

An Leas-Cheann Comhairle

Yes, just one question to the Minister.

Deputy Brian Stanley

Has an examination of the building been carried out given that the Minister and the HSE have stated that it may not be adequate in 2015 to meet HIQA standards? Has a technical examination of the building been conducted? The last time I was in it, the building looked very well. I would like an answer to that question.

Deputy James Reilly

I agree with Deputy Flanagan that we must provide for the needs of people as they grow older. That is something we absolutely endeavour to do. Those needs can be met through various mechanisms, including hospital services, home help, home care programmes, long-term care and sheltered housing. Our aim is to allow people to remain in their homes as long as possible and to ensure they are treated at the lowest level of complexity, subject to considerations of safety, timeliness and efficiency, and as close to home as possible. That is the underlying principle of policy in this area.

Deputy Stanley asked whether there has been a technical examination of the building. While there is nothing in my notes to indicate that such a review has been carried out, I have been informed verbally that assessments have been made in the past and that the cost of refurbishing the hospital and bringing it up to standard was found to be prohibitive. However, I do not wish to mislead the Dáil and will not depend on my memory in this matter. Instead I will come back to the Deputy with a written response.

To Deputy Fleming, and his time machine, I will emphasise two points. First, all of the clients will be looked after. They will certainly be assessed as to their medical needs, as is proper and correct. However, their placement will be decided upon in consultation with their relatives; that is an absolute. Second, the Deputy claims that no saving will arise because the staff will be redeployed. Staff are redeployed to keep other services open, so there is a considerable saving. As I indicated, it is my understanding that the cost associated with upgrading the hospital is prohibitive. I undertake to send a written report on that to the Deputies.

The Deputy opposite is well aware that the Government of which he was a member brought this country to financial ruin, that we are suffering as a consequence across all budgets, that we are forced into a position——

Deputy Sean Fleming

The Government is continuing the policies of its predecessor.

Deputy James Reilly

The Deputy does not want to listen. There is none so blind as he who will not see and none so deaf as he who will not listen. The bottom line is that we are obliged to make difficult decisions. We do not make them lightly, but we have little choice given the poisoned chalice passed down to us. However, the situation has improved. In regard to the moratorium on public sector recruitment, the health sector has been responsible for 45% of the reduction in numbers, even though it is responsible for only 33% of the numbers employed. We have done our part. We will continue to seek to keep within budget while maintaining services. Deputy Seamus Kirk's question will afford me an opportunity to outline how that is being done through the special delivery unit.

Accident and Emergency Services

Deputy Seamus Kirk

I thank the Ceann Comhairle for allowing me to raise this important issue for the population of the north east. Will the Minister clarify the situation at Our Lady of Lourdes Hospital, Drogheda in light of the recent announcement by Government backbenchers in the constituency that an additional €700,000 will be made available to alleviate conditions in the accident and emergency department? That announcement suggests a political motivation behind some of the decisions being taken. Are we focusing on spin or are we addressing the significant problems at this and other hospitals?

Unfortunately, the sum mentioned will not go far given the scale of the crisis at Our Lady of Lourdes Hospital. Today, 53 patients are on trolleys there, the highest number in the country. It is consistently the worst-performing hospital in the State in terms of overcrowding. This poses a major risk to patient safety and must be addressed immediately. The proposed funding of €700,000 is a short-term provision. We must know what will be done in the medium term and whether there is a long-term plan in place.

I expect that the Minister will refer in his reply to my party's tenure in government. The unit at Our Lady of Lourdes Hospital is the main accident and emergency department for the Louth-Meath hospital group. A new facility was opened in June 2010. It is three times the size of the old unit and was built at a cost of €11.5 million. The department is supported by an interim medical assessment unit, an on-site short-stay unit, a medical assessment unit at Louth County Hospital in Dundalk and a minor injuries unit at Our Lady's Hospital in Navan. The north-east regional colonoscopy screening service opened in Louth County Hospital in December 2010. In September 2010, 331 patients spent time on trolleys in Our Lady of Lourdes, which I accept is too many. However, in September 2011, under the auspices of the new Health Service Executive board which the Minister filled with civil servants from his Department, 842 patients were on trolleys, an increase of 154%.

The accident and emergency department at Navan remains open, yet there has been a leap in the number of patients on trolleys at Our Lady of Lourdes Hospital. The situation will deteriorate even further in the coming months as the winter period is traditionally the worst in emergency departments nationwide. The Irish Nurses and Midwives Organisation has described the situation as a meltdown. It is clearly causing untold human suffering for patients. The INMO has called on the Health Information and Quality Authority immediately to inspect the unsafe conditions that exists in the emergency department at Our Lady of Lourdes Hospital in Drogheda.

I appeal to the Minister to clarify the position. Will he indicate whether the funding which has been referred to by Government backbenchers in the constituency is being made available? What is the medium and longer-term plan to alleviate the State's worst pressure point in the health service?

Deputy James Reilly

I thank the Deputy for raising this issue. To tackle unacceptably long waiting times in emergency departments on a sustainable basis, immediately following my appointment I set about establishing the special delivery unit, SDU. It will not have escaped the Deputy's notice that this problem is the legacy of his Government, although, as the former Ceann Comhairle, he may claim not to have played any part. The aim of the SDU is to unblock access to acute services by improving the flow of patients through the system. The SDU is focusing initially on emergency departments and will work to support hospitals in addressing excessive waiting times for admission to hospital. Our Lady of Lourdes Hospital in Drogheda is working across several levels to reduce the time patients wait on trolleys in the emergency department. The clinical director and group general manager are fully engaged with the SDU in this regard.

As part of the process of forming an overall picture of the emergency departments situation nationally, the SDU has visited units throughout the State and conducted a data analysis. It has identified several hospitals providing unscheduled care that require support. Eight of these, including Our Lady of Lourdes Hospital in Drogheda, require a very high level of support. As part of the process of engagement with the SDU these hospitals have prepared plans setting out measures that could be taken quickly in the hospital or closely related community setting or both that would significantly relieve pressure on the emergency department by, for example, addressing delayed discharges.

This is a new approach. Staff at the SDU visit the hospital and undertake the analysis in co-operation with staff and management. Following that, the SDU asks management to set out what it considers to be required in order to address the hospital's difficulties. The SDU will discuss these proposals with the management, questioning particular costs, asking why particular actions are being taken and others not attempted. The bottom line is that we are seeking to identify how, for a limited expenditure, we can secure maximum results.

Following consideration, and as part of the overall process of SDU engagement, a package of short-term measures has been agreed for Our Lady of Lourdes Hospital in Drogheda. The supports being provided to it and other hospitals and associated community services are dependent on a range of conditions being met. These include a commitment on the part of the hospital to progress implementation of the HSE's acute medicine programme and ensure the hospital has seven-day ward discharge rounds in place. In particular, additional capacity, funded by the initiative, must not be offset by reductions elsewhere.

A sum of €725,710 is being made available in respect of proposals relating to Our Lady of Lourdes in Drogheda between now and the end of this year. The measures being taken, though aimed at easing the pressure on trolleys in Drogheda, involve Louth County Hospital in Dundalk and Our Lady's Hospital in Navan, as well as measures in the community. To reiterate what I said elsewhere, no part of the health service works in isolation.

The measures include additional assisted discharge packages including home help, home care and funding for aids and appliances, which will be implemented immediately; the extension of the hours of the acute medical assessment unit at Drogheda to 18 hours a day seven days a week, which will happen by the end of the month; the opening of eight medical beds in Drogheda by the end of the month; the opening of an additional 28 low-acuity beds in Louth and Navan; and the opening of an additional 27 low-acuity beds in the community.

The funding support is dependent on the hospital meeting the performance conditions set down. The SDU will be monitoring the position closely. Owing to its central position and the expertise that is available to the special delivery unit, it is able to develop and roll out solutions that will quickly resolve situations as they arise. I anticipate that the plans being implemented in Our Lady of Lourdes Hospital will quickly address the unacceptable levels of overcrowding in its emergency department.

Deputy Seamus Kirk

What will be the provision in late winter and early spring? Will there be a continuation of this support or will additional financial support be made available to ensure the winter months and the early spring months, which will represent a real pressure point for the hospital, will be addressed? Will that be borne in mind and will additional resources be allocated to it?

On the logistics of what is proposed, a number of beds in the Louth County Hospital, Dundalk were sold to a Libyan charity. Will they be replaced? Is there a capital provision in this arrangement to replace beds in the hospital? It will take additional people to staff the additional beds when they are provided in the Louth County Hospital. Will the issue of the moratorium be revisited to ensure there are adequate staff to cater for the patients to be accommodated in the hospital?

Deputy James Reilly

Sufficient funds are in place to ensure appropriately staffed beds are available in the hospital mentioned. The Deputy should bear in mind that we are discussing low acuity and not high acuity.

An analysis was done by the SDU on the IT system that was installed at a cost of less than €250,000. Although it is not completely installed throughout the system yet, it is a fraction of the €10 million we were told it would cost and it was completed in 98 days rather than in 18 months. We now know that early January is the key crunch point. It is not as a result of increased numbers attending the emergency department, but as a result of work practices in hospitals throughout the country. The increase in activity comes as people come back from holidays and many elective procedures take place. Those need to be spread throughout the year to avoid creating the double crunch we get.

I can reassure the Deputy that there will be sufficient resources in my view to deal with the problems. However, this was never about more money but about the way we work. It is about more flexibility from consultants in giving us the Saturday and Sunday discharges we have discussed here. It is about diagnostics at the weekend so that X-rays, and ultrasound and CT scans can be read and patients discharged. It is about nurses working differently and not expecting to work the entire week in three days. It is about NCHDs, GPs and pharmacists working differently. It is about the core principle of treating the patient at the lowest level of complexity that is safe, timely, efficient and as near to home as possible. We do not want the wrong overqualified person dealing with a problem that could be dealt with by somebody at an entirely lower level much more conveniently to the patient and at much less cost to the State.